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surgical apgar

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https://www.readbyqxmd.com/read/29184910/adapting-the-surgical-apgar-score-for-perioperative-outcome-prediction-in-liver-transplantation-a-retrospective-study
#1
Amy C S Pearson, Arun Subramanian, Darrell R Schroeder, James Y Findlay
Background: The surgical Apgar score (SAS) is a 10-point scale using the lowest heart rate, lowest mean arterial pressure, and estimated blood loss (EBL) during surgery to predict postoperative outcomes. The SAS has not yet been validated in liver transplantation patients, because typical blood loss usually exceeds the highest EBL category. Our primary aim was to develop a modified SAS for liver transplant (SAS-LT) by replacing the EBL parameter with volume of red cells transfused. We hypothesized that the SAS-LT would predict death or severe complication within 30 days of transplant with similar accuracy to current scoring systems...
November 2017: Transplantation Direct
https://www.readbyqxmd.com/read/29173311/predicting-mortality-or-intestinal-failure-in-infants-with-surgical-necrotizing-enterocolitis
#2
COMPARATIVE STUDY
Darshna Bhatt, Curtis Travers, Ravi M Patel, Julia Shinnick, Kelly Arps, Sarah Keene, Mehul V Raval
OBJECTIVE: To compare existing outcome prediction models and create a novel model to predict death or intestinal failure (IF) in infants with surgical necrotizing enterocolitis (NEC). STUDY DESIGN: A retrospective, observational cohort study conducted in a 2-campus health system in Atlanta, Georgia, from September 2009 to May 2015. Participants included all infants ≤37 weeks of gestation with surgical NEC. Logistic regression was used to model the probability of death or IF, as a composite outcome, using preoperative variables defined by specifications from 3 existing prediction models: American College of Surgeons National Surgical Quality Improvement Program Pediatric, Score for Neonatal Acute Physiology Perinatal Extension, and Vermont Oxford Risk Adjustment Tool...
December 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29146268/surgical-apgar-score-predicts-30-day-morbidity-in-elderly-patients-who-undergo-non-laparoscopic-gynecologic-surgery-a-retrospective-analysis
#3
Kazumi Kurata, Yoko Chino, Akiko Shinagawa, Tetsuji Kurokawa, Yoshio Yoshida
INTRODUCTION: The aim of this study was to determine whether a preoperative health status index and intraoperative data could predict perioperative morbidity and mortality in women over the age of 65 years undergoing surgery for gynecologic disorders. METHODS: The medical records of 68 female patients who were ≥65 years of age and who underwent surgery under general anesthesia in our institute from January 2014 to December 2015 were retrospectively reviewed. Preoperative data were extracted from a database and included comorbidities, American Society of Anesthesiologists physiological status classification, the Charlson Comorbidity Index, the Subjective Global Assessment 2011 revision, the subjects' risk of falling, body mass index, and age...
November 13, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/29035696/the-reliability-of-surgical-apgar-score-in-predicting-immediate-and-late-postoperative-morbidity-and-mortality-a-narrative-review
#4
Abhijit Nair, Aanchal Bharuka, Basanth Kumar Rayani
Surgical Apgar Score is a simple, 10-point scoring system in which a low score reliably identifies those patients at risk for adverse perioperative outcomes. Surgical techniques and anesthesia management should be directed in such a way that the Surgical Apgar Score remains higher to avoid postoperative morbidity and mortality.
October 13, 2017: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/29033722/effect-of-intravenous-phenylephrine-infusion-on-dose-requirement-of-intrathecal-plain-levobupivacaine-for-cesarean-section-a-placebo-controlled-preliminary-study
#5
Asha Tyagi, Aanchal Kakkar, Namrata Niwal, Medha Mohta, Ashok Kumar Sethi
BACKGROUND: Phenylephrine infusion has been shown to decrease rostral spread of plain and hyperbaric local anesthetic (LA) when compared to ephedrine infusion. However, it does not result in higher dose requirement of hyperbaric LA for cesarean section. There is no trial evaluating the effect of phenylephrine infusion on ED50 of a plain intrathecal LA. METHODS: Pregnant patients with term uncomplicated singleton pregnancy undergoing elective cesarean section were given combined spinal-epidural anesthesia...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29033614/fusion-of-lower-limbs-with-severe-urogenital-malformation-in-a-newborn-a-rare-congenital-clinical-syndrome-case-report
#6
Fatemah Al Hadhoud, Abeer H Kamal, Abdulmohsen Al Anjari, Michael Fe Diejomaoh
BACKGROUND: Fused lower limbs combined with severe urogenital malformation, also known as sirenomelia, is a rare congenital clinical syndrome. The etiology is unknown, and the outcome for the affected fetus is rather uncertain. CASE REPORT: Mrs RB, a Kuwaiti woman primigravida, married to a non-consanguineous husband, had uneventful antenatal care in a private health service, until she was admitted to the Maternity Hospital, Kuwait, at 31 weeks of gestation with a 3-hour history of ruptured membranes...
2017: International Medical Case Reports Journal
https://www.readbyqxmd.com/read/28986819/the-surgical-apgar-score-predicts-not-only-short-term-complications-but-also-long-term-prognosis-after-esophagectomy
#7
Akio Nakagawa, Tetsu Nakamura, Taro Oshikiri, Hiroshi Hasegawa, Masashi Yamamoto, Shingo Kanaji, Yoshiko Matsuda, Kimihiro Yamashita, Takeru Matsuda, Yasuo Sumi, Satoshi Suzuki, Yoshihiro Kakeji
BACKGROUND: The surgical Apgar score (SAS) quantifies three intraoperative factors and predicts postoperative complications, but few reports describe its usefulness in esophagectomy, and no studies to date show its correlation with long-term prognosis after esophagectomy. METHODS: This study investigated 400 cases in which esophagectomy was performed on esophageal malignant tumors at the authors' hospital from January 2007 to January 2017. In this study, SAS was defined as the sum of the scores of three parameters, namely, estimated blood loss, lowest mean arterial pressure, and lowest heart rate, with values extracted from medical records...
October 6, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28937460/utility-of-the-surgical-apgar-score-for-patients-who-undergo-surgery-for-spinal-metastasis
#8
Darryl Lau, Timothy J Yee, Frank La Marca, Rakesh Patel, Paul Park
STUDY DESIGN: Retrospective review of patients who underwent surgery for spinal metastasis between 2005 and 2011. OBJECTIVE: To assess the utility of the surgical Apgar score (SAS) in patients who underwent surgery for spinal metastasis. SUMMARY OF BACKGROUND DATA: Surgery for spinal metastasis can be associated with relatively high morbidity and mortality. Consequently, identifying patients at risk for major postoperative complications is important...
October 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28794836/comparing-epidural-surgical-anesthesia-and-spinal-anesthesia-following-epidural-labor-analgesia-for-intrapartum-cesarean-section-a-prospective-randomized-controlled-trial
#9
Hea-Jo Yoon, Sang-Hwan Do, Yeo Jin Yun
BACKGROUND: The conversion of epidural labor analgesia (ELA) to epidural surgical anesthesia (ESA) for intrapartum cesarean section (CS) often fails, resulting in intraoperative pain. Spinal anesthesia (SA) can provide a denser sensory block than ESA. The purpose of this prospective, non-blinded, parallel-arm, randomized trial was to compare the rate of pain-free surgery between ESA and SA following ELA for intrapartum CS. METHODS: Both groups received continuous epidural infusions for labor pain at a rate of 10 ml/h...
August 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28743257/longer-travel-time-to-district-hospital-worsens-neonatal-outcomes-a-retrospective-cross-sectional-study-of-the-effect-of-delays-in-receiving-emergency-cesarean-section-in-rwanda
#10
Joseph Niyitegeka, Georges Nshimirimana, Allison Silverstein, Jackline Odhiambo, Yihan Lin, Theoneste Nkurunziza, Robert Riviello, Stephen Rulisa, Paulin Banguti, Hema Magge, Martin Macharia, Regis Habimana, Bethany Hedt-Gauthier
BACKGROUND: In low-resource settings, access to emergency cesarean section is associated with various delays leading to poor neonatal outcomes. In this study, we described the delays a mother faces when needing emergency cesarean delivery and assessed the effect of these delays on neonatal outcomes in Rwanda. METHODS: This retrospective study included 441 neonates and their mothers who underwent emergency cesarean section in 2015 at three district hospitals in Rwanda...
July 25, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28646578/the-impact-of-a-novel-transendometrial-approach-for-caesarean-myomectomy-on-obstetric-outcomes-of-subsequent-pregnancy-a-longitudinal-panel-study
#11
S Y Huang, S W Shaw, S Y Su, W F Li, H H Peng, P J Cheng
OBJECTIVE: To evaluate the obstetric and surgical outcomes of a novel transendometrial approach for myomectomy during caesarean section in subsequent pregnancies. DESIGN: Longitudinal panel study. SETTING: Chang Gung Memorial Hospital, Taiwan, with approximately 5000 births per annum. POPULATION: Pregnant women complicated with uterine myoma. METHOD: Sixty-three pregnant women who received transendometrial myomectomy during the first caesarean delivery reported a subsequent live pregnancy and planned an elective repeat caesarean delivery...
June 24, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28605923/bacterial-sepsis-in-neonates-single-centre-study-in-a-neonatal-intensive-care-unit-in-bosnia-and-herzegovina
#12
Izeta Softić, Husref Tahirović, Vincenzo Di Ciommo, Cinzia Auriti
OBJECTIVE: The aim of the study was to evaluate the incidence, mortality, risk factors, aetiology and the susceptibility to antibiotics of the bacteria responsible for sepsis. MATERIAL AND METHODS: A single centre, prospective, observational study, involving 200 neonates admitted over 12 months to the NICU of the University Children's Hospital, Tuzla, Bosnia and Herzegovina. RESULTS: The crude incidence of all neonatal sepsis was 68.0% (136/200) and that of late-onset sepsis (LOS) was 48...
May 2017: Acta Medica Academica
https://www.readbyqxmd.com/read/28475684/the-use-of-extracorporeal-membrane-oxygenation-in-neonates-with-severe-congenital-diaphragmatic-hernia-a-26-year-experience-from-a-tertiary-centre
#13
Ricky Vaja, Ahmed Bakr, Annabel Sharkey, Vijay Joshi, Gail Faulkner, Claire Westrope, Chris Harvey
OBJECTIVES: Neonates with severe congenital diaphragmatic hernia requiring extracorporeal membrane oxygenation (ECMO) have a high rate of mortality. There is controversy regarding optimal time of surgical intervention. We present our data over a 26-year period. METHODS: We analysed data from our Extracorporeal Life Support Organization registry forms between 1989 and 2015, in order to determine the factors affecting survival outcome for repair of congenital diaphragmatic hernia with ECMO as a bridge to surgery and/or recovery...
September 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28464255/surgical-apgar-score-sas-predicts-perioperative-morbidity-mortality-and-length-of-stay-in-patients-undergoing-esophagectomy-at-a-high-volume-center
#14
Danica N Giugliano, Andrew Morgan, Francesco Palazzo, Benjamin E Leiby, Nathaniel R Evans, Ernest L Rosato, Adam C Berger
BACKGROUND: Esophagectomy carries considerable morbidity. Many studies have evaluated factors to predict patients at risk. This study aimed to determine whether the surgical Apgar score (SAS) predicts complications and length of stay (LOS) for patients undergoing esophagectomy. STUDY DESIGN: We evaluated 212 patients undergoing esophagectomy. Postoperative complications were graded using the Clavien-Dindo scale and the SAS was determined. Association of SAS with incidence of complications was evaluated using the Cochran-Armitage trend test between grouped SAS scores (0-2, 3-4, 5-6, 7-8, 9-10) and each of the outcomes...
September 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28420498/intraoperative-aortic-balloon-occlusion-in-patients-with-placenta-previa-and-or-placenta-accreta-a-retrospective-study
#15
Fangyuan Luo, Lan Xie, Ping Xie, Siwei Liu, Yue Zhu
OBJECTIVE: To introduce the primary experience of using aortic balloon catheters during cesarean section for placenta previa and/or placenta accreta. MATERIALS AND METHODS: From January 2013 to May 2015, 43 patients who were preoperatively diagnosed with major placenta previa and/or placenta accreta and who underwent prophylactic aortic catheterization before caesarean section (CS) were included in the study. We analyzed the clinical data of the study population...
April 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28397204/outcomes-of-the-patients-diagnosed-incidentally-appendicitis-during-cesarean-section
#16
Mehmet Kulhan, Nur Gozde Kulhan, Umit Nayki, Cenk Nayki, Pasa Ulug, Nahit Ata, Hulya Toklucu
OBJECTIVES: Appendicitis is the most common condition leading to an intraabdominal operation for a non obstetric problem in pregnancy and diagnosis of appendicitis is complicated by the physiologic and anatomic changes that occur during pregnancy. Although a surgical procedure carries the risk of fetal loss or preterm delivery, delay in diagnosis also increases the risk of complications in both mother and fetus. In this report we present our experience and analyze clinical characteristic and the pregnancy outcomes of appendicitis diagnosed incidentally during cesarean in the third trimester...
2017: Ginekologia Polska
https://www.readbyqxmd.com/read/28384177/application-of-surgical-apgar-score-in-intracranial-meningioma-surgery
#17
Shih-Yuan Hsu, Chien-Yu Ou, Yu-Ni Ho, Yu-Hua Huang
Surgical resection is the main therapeutic option for intracranial meningiomas, but it is not without significant morbidities. The Surgical Apgar Score (SAS), assessed by intraoperative blood pressure, heart rate, and blood loss, was developed for prognostic prediction in general and vascular surgery. We aimed to examine whether the application of SAS in patients undergoing craniotomy for meningioma resection can predict postoperative major complications. We retrospectively enrolled 99 patients that had undergone intracranial meningioma surgery...
2017: PloS One
https://www.readbyqxmd.com/read/28255629/validation-of-the-surgical-apgar-score-after-laparotomy-at-a-tertiary-referral-hospital-in-rwanda
#18
Christian Ngarambe, Blair J Smart, Neeraja Nagarajan, Jennifer Rickard
BACKGROUND: The surgical Apgar score (SAS) has demonstrated utility in predicting postoperative outcomes in a variety of surgical disciplines. However, there has not been a study validating the utility of the SAS in surgical patients in low-income countries. We conducted a prospective, observational study of patients undergoing laparotomy at a tertiary referral hospital in Rwanda and determined the ability of SAS to predict inpatient major complications and mortality. METHODS: All adult patients undergoing laparotomy in a tertiary referral hospital in Rwanda from October 2014 to January 2015 were included...
July 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28240343/term-twin-birth-impact-of-mode-of-delivery-on-outcome
#19
Elina Ylilehto, Outi Palomäki, Heini Huhtala, Jukka Uotila
INTRODUCTION: The main aims of this study were to compare maternal and neonatal outcomes in term twin birth according to the planned mode of delivery and to study the effects of chorionicity and inter-twin delivery time on neonatal outcome. MATERIAL AND METHODS: A single-center cohort study of 495 women with twin deliveries at ≥37(+0) weeks of gestation. Term twin deliveries were divided into a trial of labor group (TOL, 69.3%) and a planned cesarean section (CS) group (30...
May 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28209547/pregnancy-after-urinary-diversion-at-young-ages-risks-and-outcome
#20
Nina Huck, S Schweizerhof, P Honeck, A Neisius, J W Thüroff, R Stein
OBJECTIVE: To assess the urologic and obstetric outcomes during and after pregnancy following urinary diversion (UD) performed during childhood or adolescence. MATERIALS AND METHODS: From our UD database, we identified 25 women who became pregnant between 1981 and 2013. Reasons for UD were neurogenic bladder, exstrophy, trauma, sinus urogenitalis, and interstitial cystitis. Seventeen had continent cutaneous diversion, 4 had continent anal diversion, and 4 had colonic conduit...
February 14, 2017: Urology
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